Journal of Addiction Medicine最新文献_第8页

Maternal Perception of Infant Sleep and Bonding in Opioid Use Disorder. 阿片类药物使用失调症中母亲对婴儿睡眠和亲情的感知。

IF 5.5 3区医学

Journal of Addiction Medicine Pub Date : 2024-09-11 DOI: 10.1097/adm.0000000000001381

Joyce H Xu,Stephanie L Merhar,Emily A Defranco,Jennifer M McAllister,Mishka Terplan,Nichole L Nidey

{"title":"Maternal Perception of Infant Sleep and Bonding in Opioid Use Disorder.","authors":"Joyce H Xu,Stephanie L Merhar,Emily A Defranco,Jennifer M McAllister,Mishka Terplan,Nichole L Nidey","doi":"10.1097/adm.0000000000001381","DOIUrl":"https://doi.org/10.1097/adm.0000000000001381","url":null,"abstract":"OBJECTIVEInfant sleep problems are common in early infancy and can negatively influence maternal-infant bonding. As opioid-exposed neonates are at increased risk of sleep difficulties, we examined the association between maternal perception of infant sleep difficulties and maternal-infant bonding among dyads affected by maternal opioid use disorder (OUD), from birth through 6 months.METHODSWe enrolled 100 birthing people (participants) between 6 months and 2 years postpartum who had received medications for OUD during their pregnancy. Participants answered questions regarding maternal and infant characteristics, as well as the Postpartum Bonding Questionnaire (PBQ), on which higher scores indicate decreased maternal-infant bonding. Unadjusted and adjusted linear regression models were used to examine the association between infant sleep and bonding.RESULTSOf 100 study participants, 91 completed the PBQ. Of these, 55% reported difficulties with their infant's sleep during the first 6 months postpartum. Although bonding scores were overall strong, those who reported infant sleep difficulties scored on average 10.40 points higher on the PBQ (β = 10.40; 95% confidence interval, 5.94-14.85) than participants who did not report sleep difficulties, indicating the negative association between infant sleep problems and bonding. This effect remained after adjusting for relevant maternal-infant characteristics (β = 6.86; 95% confidence interval, 2.49-11.24).CONCLUSIONSIn this study among postpartum individuals with OUD, maternal perception of infant sleep problems was associated with reduced maternal-infant bonding. This relationship between infant sleep and bonding offers a target for supporting dyads affected by OUD.","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":"74 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142192433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Response to "Two Clinical Insights on Methamphetamine Withdrawal at a Safety-Net Hospital". 回应 "一家安全网医院对甲基苯丙胺戒断的两点临床见解"。

IF 4.2 3区医学

Journal of Addiction Medicine Pub Date : 2024-09-04 DOI: 10.1097/ADM.0000000000001364

Timothy E Wilens, Ronan L H Wilson, Lia Beltrame, Adam Taylor, James O'Connell

引用次数: 0

Medications for Alcohol Use Disorder among Birthing People with an Alcohol-related Diagnosis. 在被诊断患有酒精相关疾病的分娩人群中使用药物治疗酒精使用障碍。

IF 4.2 3区医学

Journal of Addiction Medicine Pub Date : 2024-09-04 DOI: 10.1097/ADM.0000000000001372

Sarah Cm Roberts, Guodong Liu, Mishka Terplan

{"title":"Medications for Alcohol Use Disorder among Birthing People with an Alcohol-related Diagnosis.","authors":"Sarah Cm Roberts, Guodong Liu, Mishka Terplan","doi":"10.1097/ADM.0000000000001372","DOIUrl":"10.1097/ADM.0000000000001372","url":null,"abstract":"Objectives: Although safety and effectiveness of medications for alcohol use disorder (AUD) are well established for adults, literature on these medications in pregnancy is limited. Given known adverse effects of untreated AUD during pregnancy, clinicians and researchers have recently begun to call for reconsidering use of medications for AUD in pregnancy. Thus, we sought to estimate the proportion of birthing people with an alcohol-related diagnosis who received a prescription for medication related to AUD treatment.Methods: Data were from Meritive MarketScan, a national private insurance claims database. The study cohort included birthing people aged 25-50 who gave birth to a singleton in the United States between 2006 and 2019 and were matched with an infant. Variables included an alcohol-related diagnosis within a year of birth and receiving a prescription for a medication related to AUD treatment. We calculated proportions with alcohol-related diagnoses who received any AUD medication and each medication type.Results: Of 1,432,979 birthing person-infant dyads, 2517 (0.18%) had an alcohol-related diagnosis. Of those with an alcohol-related diagnosis, 8.70% (n = 219) received any medication. The most common was gabapentin (4.69%, n = 118), with benzodiazepines for withdrawal as the second most common (2.19%, n = 55). Approximately 2% received naltrexone (1.91%, n = 48) and/or disulfiram (1.39%, n = 35); 0.56% (n = 14) received acamprosate. No one with an alcohol-related diagnosis received phenobarbital. Almost all medications were received postpartum.Conclusions: Very few pregnant/postpartum people with alcohol-related diagnoses are prescribed medications related to AUD treatment. Research is needed to examine whether benefits of these medications during pregnancy outweigh harms.","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Two Clinical Insights on Methamphetamine Withdrawal at a Safety-Net Hospital. 一家安全网医院对甲基苯丙胺戒断的两种临床见解。

IF 4.2 3区医学

Journal of Addiction Medicine Pub Date : 2024-09-04 DOI: 10.1097/ADM.0000000000001365

Dale Terasaki, Ryan Loh, Scott Simpson

引用次数: 0

Naloxone Stigma Among People Who Use Drugs: Characteristics and Associations With Stigma Toward Medication for Opioid Use Disorder. 吸毒者对纳洛酮的成见：吸毒者对纳洛酮的成见：对阿片类药物使用障碍的成见的特征和关联。

IF 4.2 3区医学

Journal of Addiction Medicine Pub Date : 2024-09-04 DOI: 10.1097/ADM.0000000000001377

Devin E Banks, Xiao Li, Brandon Park, Rachel P Winograd, Patricia Cavazos-Rehg

{"title":"Naloxone Stigma Among People Who Use Drugs: Characteristics and Associations With Stigma Toward Medication for Opioid Use Disorder.","authors":"Devin E Banks, Xiao Li, Brandon Park, Rachel P Winograd, Patricia Cavazos-Rehg","doi":"10.1097/ADM.0000000000001377","DOIUrl":"10.1097/ADM.0000000000001377","url":null,"abstract":"Objectives: Widespread naloxone distribution is key to mitigating opioid-related morbidity, but stigma remains a barrier. Naloxone stigma among providers, emergency responders, and the public is well-documented and associated with treatment and policy preferences, but little is known about naloxone stigma among people who use drugs (PWUD), who may be overdose first responders. This study examines naloxone stigma, its correlates, and its association with stigma toward medication for opioid use disorder (MOUD) among PWUD.Methods: We recruited 293 individuals with a history of substance misuse from facilities that provide substance use and/or health care services (retained n = 195, 54% women, 75% White). Participants completed self-report measures, including the 5-item Naloxone-Related Risk Compensation Beliefs scale.Results: One in 5 respondents agreed with beliefs that access to naloxone leads to more opioid use and less treatment seeking and is \"enabling.\" Those with nonopioid drug misuse, without prior overdose, and with fewer recovery attempts endorsed more naloxone stigma. Opioid misuse, prior overdose, and MOUD utilization were also inversely associated with MOUD stigma. There were no demographic differences in either stigma type. Naloxone stigma was positively associated with MOUD stigma in adjusted models.Conclusions: This is the first study to quantitatively examine naloxone stigma among PWUD. Findings emphasize the potential role of overdose education and naloxone distribution among those earlier in the substance use disorder course and who use nonopioid drugs. They support integrating MOUD stigma interventions into current overdose education and naloxone distribution targeted at PWUD to increase the acceptance and uptake of both medications.","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Pharmacologic Evaluation of Buprenorphine in Pregnancy and the Postpartum Period. 丁丙诺啡在孕期和产后的药理评估。

IF 4.2 3区医学

Journal of Addiction Medicine Pub Date : 2024-09-02 DOI: 10.1097/ADM.0000000000001380

Steve N Caritis, Raman Venkataramanan

{"title":"A Pharmacologic Evaluation of Buprenorphine in Pregnancy and the Postpartum Period.","authors":"Steve N Caritis, Raman Venkataramanan","doi":"10.1097/ADM.0000000000001380","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001380","url":null,"abstract":"Background: The dosing regimen in the package insert for sublingual buprenorphine is similar for pregnant and nonpregnant people despite the physiologic changes seen during pregnancy.Aims: To compare plasma buprenorphine pharmacokinetics during and after pregnancy and relate buprenorphine concentration to the pharmacodynamic endpoints of pupil diameter, Clinical Opioid Withdrawal Scale (COWS), and craving scores.Study design: Prospective cohort of 22 pregnant people undergoing 33 pharmacologic studies (6-8 hours each) during pregnancy or postpartum. Participants were on a stable daily dose of 2-8 mg sublingual buprenorphine every 6 or 8 hours. The dosing frequency was selected by the participant. On study day, baseline measurements of plasma buprenorphine, pupil diameter, COWS, and craving scores were obtained, then the usual morning dose was taken, and measurements were repeated several times over 1 dosing interval.Findings: The dose-normalized area under the plasma buprenorphine concentration time curve was significantly (P = 0.036) lower during pregnancy (155 ± 52 ng × min/mL) than postpartum (218 ± 113 ng × min/mL). Buprenorphine trough concentrations were similar at the start (1.1 ± 0.7 ng/mL) and end of a dosing cycle (1.2 ± 0.8 ng/mL) regardless of dosing frequency. Pupillary diameter, COWS, and craving scores returned to baseline as buprenorphine concentrations approached ~1 ng/mL.Conclusions: Pregnant people require a higher dose of buprenorphine to achieve concentrations comparable to nonpregnant people. There is a temporal relationship between the plasma buprenorphine concentration and the pharmacodynamic markers of pupillary diameter, COWS, and craving scores. An average plasma concentration of ~1 ng/mL was associated with the lowest level of COWS and craving scores.","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Distinct Trajectories of Prescription Opioid Exposure in Pregnancy and Risk of Adverse Birth Outcomes. 妊娠期处方类阿片暴露的不同轨迹与不良出生结果的风险。

IF 4.2 3区医学

Journal of Addiction Medicine Pub Date : 2024-09-02 DOI: 10.1097/ADM.0000000000001374

Yi Wang, Deborah B Ehrenthal, Liwei Zhang

{"title":"Distinct Trajectories of Prescription Opioid Exposure in Pregnancy and Risk of Adverse Birth Outcomes.","authors":"Yi Wang, Deborah B Ehrenthal, Liwei Zhang","doi":"10.1097/ADM.0000000000001374","DOIUrl":"10.1097/ADM.0000000000001374","url":null,"abstract":"Objectives: The aim of this study was to identify distinct trajectories of prescription opioid exposure in pregnancy-encompassing both medication for opioid use disorder (MOUD) and opioid analgesics-and explore their associations with birth outcomes.Methods: Trajectories were identified using latent class analysis among Wisconsin Medicaid-insured live births 2011-2019. Logistic regression estimated associations between these trajectories and neonatal opioid withdrawal syndrome (NOWS), small for gestational age, preterm birth, birth weight, and gestational age.Results: Of 138,123 births, 27,293 (19.8%) had prenatal opioid exposure. Five trajectory classes were identified: (1) stable MOUD treatment (5.8%), (2) inconsistent MOUD treatment (3.9%), (3) chronic analgesic use (4.2%), (4) intermittent analgesic use (7.8%), and (5) low-level use of MOUD and analgesics (78.3%). NOWS incidence per 1000 infants was 667 for class 1 (adjusted odds ratio [aOR]: 21.74, 95% confidence interval [CI]: 17.89, 26.41), 570 for class 2 (aOR: 15.35, 95% CI: 12.49, 18.87), 235 for class 3 (aOR: 19.42, 95% CI: 15.93, 23.68), 67 for class 4 (aOR: 6.23, 95% CI: 4.99, 7.76), and 12 for class 5 (aOR: 1.73, 95% CI: 1.47, 2.02). Classes 1-4 had elevated risk of small for gestational age, preterm birth, lower birth weight, and shorter gestational age, with no significant differences among these classes. Among individuals with opioid use disorder, stable MOUD treatment was associated with higher birth weights and longer gestational ages compared to inconsistent treatment, despite higher odds of NOWS.Conclusions: Early initiation and consistent MOUD treatment may improve birth weight and gestational age. For pregnant individuals with opioid use disorder using chronic analgesics, transition to MOUD may promote birth outcomes.","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cannabinoid Hyperemesis Syndrome Presumed Secondary to CBD Use: A Case Report. 推测因使用 CBD 而继发的大麻素吐逆综合征：病例报告。

IF 4.2 3区医学

Journal of Addiction Medicine Pub Date : 2024-09-02 DOI: 10.1097/ADM.0000000000001378

Emilie Lefebvre, Luc Simons, Mélanie Duval, Edouard-Jules Laforgue, Caroline Victorri-Vigneau

{"title":"Cannabinoid Hyperemesis Syndrome Presumed Secondary to CBD Use: A Case Report.","authors":"Emilie Lefebvre, Luc Simons, Mélanie Duval, Edouard-Jules Laforgue, Caroline Victorri-Vigneau","doi":"10.1097/ADM.0000000000001378","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001378","url":null,"abstract":"Introduction: Cannabinoid hyperemesis syndrome is characterized by recurrent episodes of severe nausea and vomiting, often associated with prolonged and excessive cannabis use. With the recent legalization and rising consumption of cannabidiol (CBD) in Europe and the United States, concerns have emerged about its potential role in triggering similar symptoms.Case report: A 32-year-old male with a history of cannabis, tobacco and alcohol use disorder experienced multiple cyclic vomiting episodes after switching from cannabis to CBD. Initially, the patient presented with abdominal pain and vomiting after ceasing cannabis use, with symptoms alleviated by hot showers. Three months later, similar symptoms reappeared despite abstinence from cannabis but regular CBD consumption. Over the next 6 months, recurrent episodes of abdominal pain and vomiting persisted with daily CBD use but no cannabis consumption. Clinical data, laboratory results, and treatment responses were analyzed to investigate the connection between CBD consumption and symptom onset.Discussion: The pathophysiology of cannabis-induced cyclic vomiting is poorly understood. Hypotheses include tetrahydrocannabinol accumulation in adipose tissue, pyrolytic conversion of CBD into tetrahydrocannabinol, and CBD's intrinsic effects, particularly its interaction with transient receptor potential vanilloid 1 receptors. Our analysis suggests that high doses of CBD may activate transient receptor potential vanilloid 1 receptors, inducing proemetic effects.Conclusions: Although the connection between CBD and cyclic vomiting remains uncertain, it warrants further investigation. The increasing use of CBD, perceived as a safe dietary supplement, underscores the need to understand its potential health impacts better.","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Perinatal Naloxone Care Practices: Survey Results From Persons With OUD and Providers. 围产期纳洛酮护理实践：来自 OUD 患者和医疗服务提供者的调查结果。

IF 4.2 3区医学

Journal of Addiction Medicine Pub Date : 2024-09-02 DOI: 10.1097/ADM.0000000000001376

Nichole Nidey, Heather C Kaplan, Susan Ford, Mona Prasad, Carole Lannon

{"title":"Perinatal Naloxone Care Practices: Survey Results From Persons With OUD and Providers.","authors":"Nichole Nidey, Heather C Kaplan, Susan Ford, Mona Prasad, Carole Lannon","doi":"10.1097/ADM.0000000000001376","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001376","url":null,"abstract":"Objective: Little is known about naloxone care practices for peripartum persons from the patient or provider perspectives. The objective of this study was to survey peripartum persons and providers about naloxone-related practices.Methods: Individuals who had an OUD diagnosis during a pregnancy and Ohio healthcare professionals who provide care for peripartum patients with OUD and/or infants with prenatal exposure to opioids were eligible for this study. Patient experiences were assessed through a survey codeveloped with members with lived experience of opioid use disorder. Provider perspectives were examined through a survey codeveloped by the Ohio Perinatal Quality Collaborative. Descriptive statistics and logistic regression were used to examine the proportion of participants who received or provided naloxone care practices and the effect on having a naloxone kit during the perinatal period.Results: Of the 100 peripartum participants with opioid use disorder, 24% reported receiving naloxone from their prenatal care provider and 48% reported ever having a naloxone kit during the perinatal period. Of the 63 maternal care provider participants, 32 (49%) reported discussing or prescribing naloxone to pregnant patients. Of the 62 pediatric provider participants, 10 (16%) reported that they provide naloxone information to parenting individuals of their patients.Conclusion: Study results demonstrate critical gaps in naloxone care practices for peripartum persons, emphasizing the need for targeted interventions at the patient, clinician, practice, and system levels.","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Drug Testing Interpretation in the Peripartum Setting: Results of Clinician Survey. 围产期药物检测的解释：临床医生调查结果。

IF 4.2 3区医学

Journal of Addiction Medicine Pub Date : 2024-09-01 Epub Date: 2024-06-05 DOI: 10.1097/ADM.0000000000001322

Theresa Kurtz, Elizabeth Charron, Julie Shakib, Marcela C Smid

{"title":"Drug Testing Interpretation in the Peripartum Setting: Results of Clinician Survey.","authors":"Theresa Kurtz, Elizabeth Charron, Julie Shakib, Marcela C Smid","doi":"10.1097/ADM.0000000000001322","DOIUrl":"10.1097/ADM.0000000000001322","url":null,"abstract":"Objectives: The objectives of this study were to (1) survey obstetrical and pediatric clinicians' experience, confidence, and training in maternal and neonatal drug testing interpretation; (2) determine their proficiency in drug test interpretation; and (3) assess predictors of correct interpretation.Methods: We conducted a cross-sectional survey of clinicians caring for pregnant people or newborns at an urban academic center. We assessed clinicians' demographic characteristics, experience, confidence, and prior training in interpretation of maternal and newborn drug tests. We assessed proficiency in interpreting drug tests using 11 clinical vignettes and categorized scores as poor (0-2), fair (3-5), and good (≥6) performance to facilitate data interpretation. We used descriptive statistics to summarize responses. Multinomial logistic regression was used to determine associations of clinician characteristics and score category (reference category: poor performance).Results: In total, 103 respondents completed the survey including 60 obstetrical clinicians (58.3%), 19 family medicine physicians (18.5%), 21 pediatric clinicians (20.4%), and 3 social workers (2.9%) (response rate, ~40%). The mean correct response was 4.1 (SD, 2.17; range, 0-11). Most respondent scores were fair (n = 47.6%), followed by good (n = 28.2%) and poor (n = 24.3%). Increased frequency, confidence, and training in interpreting maternal screening and confirmatory tests were associated with higher proficiency. Increased confidence and training in interpreting neonatal screening and confirmatory tests, but not frequency, were associated with higher proficiency.Conclusions: Most clinicians demonstrated fair proficiency in interpreting drug tests. Predictors of proficiency were confidence and prior training for drug test interpretation, suggesting that educational interventions could improve proficiency.","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"595-598"},"PeriodicalIF":4.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0